1497935225 NPI number — MS. SILVANA ANDREA OBERTO FNP APRN-CNP DNP

Table of content: MS. SILVANA ANDREA OBERTO FNP APRN-CNP DNP (NPI 1497935225)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497935225 NPI number — MS. SILVANA ANDREA OBERTO FNP APRN-CNP DNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OBERTO
Provider First Name:
SILVANA
Provider Middle Name:
ANDREA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
FNP APRN-CNP DNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
POLETAEV
Provider Other First Name:
SILVANA
Provider Other Middle Name:
ANDREA
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1497935225
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6400 SHAFER CT STE 300A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROSEMONT
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60018-4914
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
346-376-1702
Provider Business Mailing Address Fax Number:
224-532-2780

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
220 CONTINENTAL DR
Provider Second Line Business Practice Location Address:
SUITE 407
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19713-4311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-533-3800
Provider Business Practice Location Address Fax Number:
302-533-3801
Provider Enumeration Date:
11/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  SP011389 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: LG-0000502 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1112217 . This is a "HORIZON MERCY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9118802 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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